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Outpatient Coder 3 Certified / PB Coding

Requisition ID:

22161115

Business Unit:

Hartford HealthCare Corp.

Location:

Newington, CT

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Description

Job Schedule: Full Time
Standard Hours: 40
Job Shift: Shift 1
Shift Details:

Work where every moment matters.

Every day, approximately 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.
With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

JOB SUMMARY

Reviews and validates outpatient and professional clinical documentation and diagnostic results.  Extracts data and assigns alpha numeric codes for billing, internal and external statistical reporting, research, regulatory compliance and reimbursement.

Codes the most complex Out Patient accounts including but is not limited to the following:

  • Interventional radiology
  • Interventional cardiology
  • Endovascular

Trains and mentors coders who wish to progress to more specialize coding of the most complicated types of accounts.

Key Areas of Responsibility

Coding

  1. Applies extensive knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to assess and determine the appropriate assignment of diagnosis and procedure codes for the most complex outpatient accounts.
  2. Analyzes medical records, interprets documentation and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD‑10‑CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), modifiers, and Evaluation & Management codes utilizing designated software to include Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material as required.
  3. Enters charges for procedures that are not soft coded as instructed for certain patient types
  4. Adheres to all department coding/charging procedures, policies, guidelines and quality standards.
  5. Complete on a daily basis cases that have been assigned to them utilizing the appropriate work lists.
  6. Codes the most complex accounts, including but is not limited to the following:
  • Interventional radiology
  • Interventional cardiology
  • Endovascular
  1. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.
  2. Meets revenue cycle goals (Key Performance Indicators (KPIs) and Productivity Standards).

Issue Resolution

  1. Reviews claim edits and revises coding/charging as appropriate for specific range of ICD-10-CM/CPT/HCPCS codes. 
  2. Reviews accounts returned from various departments and processes corrections for clean claim submission or posts claim denial review for appeal.

Communication

  1. Seeks clarification from physicians or other staff in cases where documentation is absent, ambiguous, or contradictory.
  2. Makes corrections based on collaboration with clinician or designee.

Training/Leadership

  1. If required, trains new coders to become acclimated to the environment, and understand internal coding policies and procedures and documentation guidelines.
  2. Trains and mentors coders who wish to progress to more specialize coding of the most complicated types of accounts.
  3. Advances the team by influencing desired H3W Leadership Behaviors
  4. Supports and participates in special projects and assignments.

Qualifications

REQUIREMENTS AND SPECIFICATIONS

Education:

  • Associate’s Degree or equivalent experience                                          

Experience:

  • Three to four years of progressive on-the-job experience in an acute care hospital or physician required.
  • Four years or more of progressive on-the-job experience in an acute care hospital or physician office preferred.

Licensure, Certification, Registration:

  • CPC, CPCH, or CCS certification required and maintained thereafter.
  • Certified Interventional Radiology Cardiovascular Coder (CIRCC) certification.

Language Skills

  • Strong written and verbal communication skills.

Knowledge, Skills and Ability Requirements:

  • ICD‑10-CM diagnostic and CPT/HCPCS procedure codes
  • Clinical information related to responsibility areas
  • Microsoft Office Products; Word, Excel
  • Encoder and/or CAC

Skills:

  • Read, write and speak English proficiently.
  • Strong analytical capabilities.
  • Excellent organizational skills.
  • Proficiently read and interpret physician writing.

Strong ability to:

  • Function independently.
  • Handle multiple priorities.
  • Listen and acknowledge ideas and expressions of others attentively.
  • Converse clearly using appropriate verbal and body language.
  • Collaborate with others to achieve a common goal through mutual cooperation.
  • Influence others for positive and productive outcomes.
  • Utilize coding subject matter expertise to support new specialized coders and other projects.
  • Work across the Hartford HealthCare System.

We take great care of careers.

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.

 
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